Korean J Orthod.  2020 Jul;50(4):238-248. 10.4041/kjod.2020.50.4.238.

Effects of the long-term use of maxillary protraction facemasks with skeletal anchorage on pharyngeal airway dimensions in growing patients with cleft lip and palate

Affiliations
  • 1Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
  • 2Department of Dentistry, Graduate School, Seoul National University, Seoul, Korea
  • 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
  • 4Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul, Korea
  • 5Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
  • 6Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea

Abstract


Objective
To investigate the effects of the long-term use of a maxillary protraction facemask with miniplate (FM-MP) on pharyngeal airway dimensions in growing patients with cleft lip and palate (CLP).
Methods
The study included 24 boys with CLP (mean age, 12.2 years; mean duration of FM-MP therapy, 4.9 years), divided into two groups according to the amount of A point advancement to the vertical reference plane (VRP): Group 1, > 4 mm; Group 2, < 2 mm; n = 12/group. After evaluating the skeletodental and airway variables using lateral cephalograms acquired before and after FM-MP therapy, statistical analyses were performed.
Results
Group 1 showed greater forward and downward displacements of the posterior maxilla (posterior nasal spine [PNS]-horizontal reference plane [HRP]; PNSVRP), greater increase in ANB, more forward tongue position (tongue tip-Pt vertical line to Frankfort horizontal plane), and greater increase in the oropharynx (superior posterior airway space [SPAS]; middle airway space [MAS]) and upper nasopharynx (PNS-adenoid2) than did Group 2. While maxillary advancement (A-VRP and PNS-VRP) correlated with increases in SPAS, MAS, and PNS-adenoid2, downward displacement of the PNS (PNS-HRP) correlated with increases in SPAS, MAS, PNSadenoid1, and PNS-adenoid2, and with a decrease in vertical airway length (VAL). Mandibular forward displacement and decrease in mandibular plane correlated with increases in MAS.
Conclusions
FM-MP therapy had positive effects on the oropharyngeal and nasopharyngeal airway spaces without increases in VAL in Group 1 rather than in Group 2. However, further validation using an untreated control group is necessary.

Keyword

Growing patients with cleft lip and palate; Maxillary protraction; Facemask with miniplate; Pharyngeal airway dimension
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